Microvascular free flap technology provides a valuable means of transferring large flaps in one procedure, however, there are several major disadvantages. Microvascular free flaps are inappropriate for the reconstruction of small defects. The procedure is time-consuming and requires a skilled microvascular surgeon. Sufficiently large recipient vessels must be found. In addition, it is not uncommon to lose the flap from thrombosis of the anastomosed vessels.
It is known from past experience with tube pedicle flaps and cross leg flaps that the transferred flap is revascularized by the recipient bed in a relatively short time allowing for eventual transection of the pedicle, the distal part of the flap now supported totally by the recipient bed.
Artificial blood has heretofore been investigated for use in transfusion and organ preservation studies. Three types of artificial blood, i.e. free hemoglobin solutions, chelating agents, and perfluorocarbon emulsions have been investigated since the late 1960's in the preservation studies. Commercially available perfluorocarbon emulsion, Fluosol-DA 20 1/1 has been available for research purposes as it is capable of carrying large quantities of dissolved oxygen and carbon dioxide. This Fluosol emulsion is a mixture of perfluorodecalin and perfluorotripropylamine emulsified with Pluronic F68 and stabilized with egg yolk phosphatide. This emulsion is stored frozen until ready for use, at which time it is thawed and water, glycerol, solutes, glucose, and hydroxytethyl starch (an oncotic) are added.